Bacteria into bloodstream caused by oral probiotics based on whole genome sequencing: A case report.

RATIONALE

Bacillus licheniformis and Lactiplantibacillus plantarum are facultative anaerobes and gram-positive bacteria. They are commonly included in probiotic preparations and are administered orally in clinical practice to promote a balanced gut microbiota.

PATIENT CONCERNS

An 85-year-old man with irritable bowel syndrome and reflux esophagitis underwent distal pancreatectomy and was administered oral probiotics. Blood culture was positive for B. licheniformis and L. plantarum. We conducted whole-genome sequencing for homology analysis and pathogenicity prediction of the strains isolated from the patient's blood culture and oral probiotics.

DIAGNOSIS

The initial diagnosis was bacterial entry into the bloodstream resulting from the consumption of B. licheniformis and L. plantarum probiotic preparations.

INTERVENTIONS

The patient was treated with discontinuation of oral probiotics and timely administration of antibiotics.

OUTCOMES

Follow-up blood culture results after treatment were negative.

LESSONS

Probiotics are generally considered relatively safe but should be preceded by risk screening in vulnerable populations. Whole-genome sequencing revealed the potential risks of probiotic use through homology analysis and prediction of virulence factors and antibiotic resistance.